This review seeks to demonstrate how the social and economic dimensions of sustainability need to be considered alongside its environmental dimensions. This is particularly important when, as in the case of the Nordic Nutrition Recommendations (NNRs), policymakers are attempting to address the twin goals of health and sustainability. For a policy that might make good sense when seen in purely environmental terms, it might not prove sustainable in social and economic terms – if it is too costly, it exacerbates existing inequalities or has detrimental effects on public health. There are some ‘win-wins’ in the field of health and sustainability policy. However, difficult choices between competing policy options will occur, similar to those facing ordinary consumers in their everyday lives. Being clear about the way food is framed as an issue and how different framings shape policy outcomes is a useful way forward in addressing the inevitable trade-offs and compromises between competing objectives.